Individual
BAILEY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2001 KIRKWOOD BLVD, SOUTHLAKE, TX 76092-1590
(817) 756-8600
Mailing address
280 W RENNER RD APT 2326, RICHARDSON, TX 75080-1355
(817) 629-0053
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216770
TX
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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